In a healthcare environment, a number of clinical items are required to treat a patient during a clinical event or encounter. For example, a variety of medications, instruments, supplies and pieces of equipment are required to perform a surgical procedure. While certain types of clinical items are required by all physicians for each kind of procedure, most physicians have preferences as to the specific configuration, brand, model or quantity of clinical items used to perform each type of procedure. Additionally, the preferred clinical items may include optional items and incidental items that other physicians do not use when performing the same operation.
Typically, each physician develops a preference card containing a list of clinical items that the particular physician prefers to use for a particular procedure. This list of clinical items is referred to as a pick list. Each preference card also includes documentation relevant to preparing for the procedure and documenting the events that occur before, during and after the procedure. These preference cards are stored either physically or electronically at the hospital at which the procedure will be performed. In order to assemble the clinical items for a procedure, the appropriate preference card is first selected. Then, the clinical items appearing on the pick list are removed from the hospital's inventory and placed either directly in the operating room or on a surgical cart that is subsequently located in the operating room.
While this process provides the physician with the clinical items identified by the preference card, the process does not account for variations in the pick list attributable to the particular patient at the center of the clinical event. For instance, in most cases, the pick list of the preference card includes a number of items that are not needed for the particular patient since the pick list is built for patients of all different ages, sizes and types. In some cases, the patient may be allergic to a particular item included on the preference card. It is typically the responsibility of the hospital personnel assembling the clinical items to remove the inappropriate clinical item from the printed pick list from which the hospital personnel is operating.
This process is deficient for a number of reasons. By allowing clinically inappropriate items into the operating room (or other healthcare setting), an inappropriate item may inadvertently or unknowingly contact the patient and adverse or atypical effects may follow. Likewise, the changes to the documentation portion of the procedure must be made manually, and similar shortcomings are encountered. Further, larger inventories are required at the clinical facility, and additional opportunities for mistakes are created due to the assembly of unnecessary items. For these and a number of reasons, the preference card is poorly suited to manage the inventory of the hospital, charge the patient for items used during the procedure or otherwise manage the administration processes of the hospital.
Modern healthcare information systems have failed to solve these problems. In at least one system, a warning may be provided to the user of the information system that a clinical item on the pick list may be harmful to some patients. However, this system requires the user of the computer system to receive the notification and to adjust the pick list. Additionally, these changes are entered by the user manually, and the corrected list is not distributed to all of the supply rooms around the hospital. Thus, the system suffers from the same drawbacks as conventional methods of managing preference cards. Accordingly, there is a need for an effective system and method for automatically selecting the clinical items and documentation for a clinical event based on patient-specific information to improve patient safety. A need also exists for a system and method for completely and accurately identifying the clinical items used at the point of care (or admission) and initiating administrative and clinical processes based on the complete and accurate list of items used at the point of care. Still another need is for a system and method for managing items of a pick list to reduce liability and produce efficiencies not previously realized. There is yet another need for a system and method that accesses information regarding newly discovered knowledge about the appropriateness of a clinical item for a person, and utilizes the knowledge by applying rules to safely and effectively treat a patient.